California among leaders in expanding access to health coverage

The countdown has started. In 100 days, starting Oct. 1, millions of families across the nation will have an opportunity to enroll in health coverage through the Affordable Care Act (ACA), also known as Obamacare.

The full benefits of the law will be most apparent and available to residents of California. This is because California, due to its active role in implementing the historic health reform law, is expected to be one of the model states for the rest of the nation. As a result, California will demonstrate the vast, potential benefits of the ACA.

Here are some other things about the law to watch for, as we approach and get beyond the Oct. 1 milestone.

First, the public's focus on the ACA will become increasingly personal and decreasingly political. The closer we get to Oct. 1, families will shift their focus to the nuts and bolts of the new law and how it affects their lives. They will be able to pick and enroll in a health plan and, for the first time, get financial help to reduce out-of-pocket premium costs.

Families who can't pay for health coverage today will be looking for details about the new premium subsidies that will make health insurance much more affordable.

Consumers seeking increased value for their health care dollars will learn how new insurance marketplaces give them real and meaningful choices -- choices that put consumers in the driver's seat, enabling them to select health plans best suited for their needs, with access to physicians they trust.

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People with diabetes, asthma or cancer -- whether they currently have coverage or will be looking for coverage -- will seek assurance that insurance companies can no longer deny coverage, or charge discriminatory premiums, due to their pre-existing conditions.

While some Republican leaders pledge that the ACA will be a top issue in the 2014 elections, political rhetoric will become a sideshow as we move closer to Oct. 1: What will really matter will be how the ACA, in the most practical ways, affects the lives of Californians and other American families.

Second, there will be significant and perceptible differences from one state to another in terms of health coverage, costs, and quality of care -- with states such as California that actively participate in all provisions of the law faring much better.

These differences between states will show up in a number of ways. For example, states that accept generous federal funding to expand Medicaid coverage for low-income families will show remarkable improvements in reducing uninsured rates. States that turn a cold shoulder to those who need help the most won't see these reductions.

States with larger numbers of on-the-ground helpers, sometimes called "navigators" or "assisters," will help their residents much more effectively to secure premium subsidies and to obtain coverage that is most responsive to their families' needs.

And states that implement active oversight of their insurance marketplaces will do appreciably better in decelerating decades of premium increases.

Third, prospective and actual advances among active, cooperating states such as California will slowly but surely lead to less recalcitrance among governors and legislators in states that heretofore resisted, or even obstructed, the ACA's implementation.

Already, eight conservative governors -- Jan Brewer of Arizona, Chris Christie of New Jersey, Jack Dalrymple of North Dakota, John Kasich of Ohio, Susana Martinez of New Mexico, Brian Sandoval of Nevada, Rick Scott of Florida and Rick Snyder of Michigan -- have declared their support for the Medicaid expansion, understanding that it would be an act of fiscal malpractice to turn down this federal funding.

And when other benefits of ACA implementation in active states become clearer, additional Republican governors will want to follow their lead.

As a result, effective implementation of the new health reform law will spread throughout the country, and this will enable our nation to move closer to affordable, quality health coverage and care for all Americans.

Ron Pollack is the founding executive director of Families USA, the national organization for health care consumers. He is also the founding board chair of Enroll America.